Changing Paradigms in Research: Do We Need to Rethink the Future?

Abstract

Evidence-based practice is the current buzz-word of healthcare practice. It draws on a positivist approach to research centred on the randomised controlled trial. While it is imperative that palliative care embrace evidence-based approaches to patient and family care, at least two key barriers exist. Firstly, palliative care developed as a reaction against positivist science and its approaches to healthcare provision. Consequently, its field of inquiry, and what it counts as evidence, is significantly broader than can be assessed using randomised controlled trials. Secondly, even when appropriate, attempts to conduct randomised controlled trials in palliative care have largely failed. This paper explores the relationship between palliative care and evidence-based practice through a critique of randomised controlled trials as the benchmark for evidence in palliative care.